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ARCHIVED REPORTS XR0003533
EnvironmentalHealth
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2575
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2900 - Site Mitigation Program
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PR0541989
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ARCHIVED REPORTS XR0003533
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Entry Properties
Last modified
6/21/2019 8:29:56 PM
Creation date
6/21/2019 3:56:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003533
RECORD_ID
PR0541989
PE
2950
FACILITY_ID
FA0024100
FACILITY_NAME
COUNTRY CLUB VALERO
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12302012
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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SEP 1 195 10 56 FROM ERICKSON PAGE 002 <br /> r20564 <br /> DAY OR NIGHT CE RTIF' ICATE NO. <br /> TELEPHONE CUSTOMER <br /> (314) 235-1393 CERTIFIED SERVICES COMPANY _ <br /> 2S5 Parr Boulevard • Richmond,California 94801 ,OR NO <br /> JOSE ME <br /> 0 :5 5 <br /> FOUR INC . TANK NO 15704 <br /> LOCATION DATE 8 TIME3�- <br /> TEST METHOD LAST PRODUCT <br /> This is to certify that I have personally determined that this tank is in accordance with the American <br /> Petroleum Institute and have found the condition to be in accordance with Its assigned designation. <br /> This certificate is based on conditions existing at the time the inspection herein set forth was <br /> completed and is issued subject to compliance with all qualifications and Instructions. <br /> TANK SIZE 5000 GALLON TANK CONDITION SAFE FOR FIRE <br /> _ o <br /> REMARKSE AEOVE NUMBERED TANK HAS SEEN <br /> E;2ICKSQN, !NC. HEREBY CERTIFIES THAT THE. <br /> OPEN P <br /> WASTE FACILITY. <br /> �+ T <br /> �' <br /> SHIPPED TO US FOR PROCESSING <br /> In the event of any physical or atmospheric changes affecting the gas-free conditions of the above tanks, or if in any doubt, <br /> immediately stop all hot work and contact the undersigned This permit is valid for 24 hours if no physical or atmospheric <br /> changes occur <br /> STANDARD SAFETY DESIGNATION content of the atmosphere is at least <br /> SAFE FOR MEN Means that in the compartment or space so designated (a) The oxygen <br /> 19 5 percent by volume, and that (b) Toxic materials in the atmosphere are within permissable concentrations, and (c) In the <br /> judgment of the inspector, the residues are not capable of producing toxic materials under existing atmospheric conditions <br /> while maintained as directed on the Inspector's certificate <br /> SAFE FOR FIRE Means that in the compartment so designated (a) The concentration of flammable materials In the <br /> atmosphere is below 10 percent of the lower explosive limit, and that (b) in the judgment of the Inspector, the residues are <br /> not capable of producing a higher concentration that permitted under existing atmospheric conditions in the presence of fire <br /> and while maintained as directed on the Inspector's certificate, and further, (c) All adjacent spaces have either been cleaned <br /> sufficiently to prevent the spread of fire, are satisfactorily inerted, or in the case of fuel tanks, have been treated as deemed <br /> nLoessarye inspector <br /> d pr entative acknowledges receipt of this certificate and understan Condi � ' and limitations under <br /> d <br /> REPRESENTATIV (! TITLE NSPECTOR <br /> Ca5B <br />
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